Journal of clinical monitoring and computing
-
J Clin Monit Comput · Jun 2015
Case ReportsFall in inspired oxygen and anaesthetic agent concentrations during change of soda lime absorber.
Following an episode of reduction in inspired oxygen concentration (FiO(2)) and inhalational agent concentration (Fi agent) during the changing of a soda lime absorber, We conducted an in vitro experiment to understand the impact of disconnection of the absorber on inspired gas dilution at different fresh gas flows. We found that both in Dräger Fabius GS and Primus anaesthesia work stations, disconnection of the absorber caused progressive reduction in FiO(2) and Fi agent as the FGF was decreased. The operating principle of fresh gas decoupling (FGD) valve is a potential source of this complication, which must be kept in mind while changing the soda lime during the course of surgery where an anaesthetic work stations utilizing FGD valves are used.
-
J Clin Monit Comput · Jun 2015
Observational StudyCan short-term heart rate variability be used to monitor fentanyl-midazolam induced changes in ANS preceding respiratory depression?
Opioids have an occasional but high-risk side effect of respiratory depression. The detection of critical respiratory depression usually occurs after the event. Earlier detection would be beneficial in preventing increased morbidity and mortality of 0.01 % patients receiving analgesic opioids. ⋯ No significant change before critical respiratory events was observed in traditional, spectral power, respiratory or other indices. One index, PolVar20, indicated a burst of sympathetic activity preceding respiratory depression similar to sleep apnoea arousals that restore airway patency. Before its usefulness in early detection of airway tone can be determined, PolVar20 requires further work: a statistical method for highly skewed distributions, auto adjustment for baseline variability, and detecting a range of sympathetic responses to apnea.